SİSTEMİK LUPUS ERİTEMATOSUSDA İV CYCLOPHOSPHAMİDE VE ORAL PREDNİZOLONDAN OLUŞAN İMMUNSUPRESİF TEDAVİNİN ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Sistemik Lupus Eritematosus (SLE) bir immunkompleks hastalığıdır. Bu çalışmada SLE vakalarında IV cyclophosphamide (CPM) ve oral prednizolondan oluşan immunsupresif tedavinin etkinliği değerlendirilmiştir. 1999-2001 yılları içinde SLE tanısı konulan; immunsupresif, antitrombosit ve ACE inhibitörler ile en az 6 ay tedavi edilen 10 olgunun tedaviye yanıtları incelendi. Tamamı erişkin gruptan olan hastaların yaş ortalaması 29±4,6 (20-35) yıl idi. Vakaların 9'u kadın ve 1'i erkek idi. 9'u nefritik sendrom, 1'i nefrotik sendrom kliniğinde olup 9'unda hipertansiyon vardı. 12 ay süre ile takip edilen 10 hastanın proteinüri/gün değeri; başlangıçta 2,5±0,6 gr/dl iken 3. ayda 1,3±0,4 gr/dl, 6. ayda 1,19±0,2 gr/dl, 12. ayda 1,1±0,1 gr/dl'ye düştü (p<0.01). Vakaların başlangıçta kreatinin klerensi 60,7±28,6 ml/dk idi, daha sonraki takiplerinde ise istatiksel olarak anlamlı bir farlılık yoktu (p>0.05). Sonuç olarak SLE'de immunsupresif olarak kullandığımız İV CPM ve oral prednizolon tedavisinin yararlı olduğu görülmüştür.

EVALUATION OF THE EFFICACY OF IMMUNOSUPPRESSIVE TREATMENT THAT CONSISTED OF CYCLOPHOSHOMIDE IV AND ORAL PREDNISONE IN SYSTEMIC LUPUS ERYTHEMATOSUS

Systemic lupus erythematosus (SLE) is a immunecomplex disease. In this study the efficacy of immunosuppressive treatment that consisted of cyclophohopamide IV and oral prednizolon were evaluated on SLE patients. Treatment response of 10 patients who were diagnosed as SLE between 1999-2001 and were treated with immunosuppressives, antithrombolytics and ACE inhibitors at least six months. All of the patients were adult and mean age of them was 29±4,6 (20-35) years. 9 of them were women and 1 of them was man. 9 of them were nephritic syndrome, 1 of them was nephrotic syndrome and 9 of them were hypertensive. Protein in the urine/day of 10 patients that were followed up 12 months, was 2,5±0,6 gr/dl initially and then was 1,3±0,4 gr/dl at third month, was 1,19±0,2 gr/dl at sixth month and was 1,1±0,1 gr/dl at 12 month (p<0.01). Initially mean creatinine clearance result of patients was 60,7±28,6 ml/min; there wasn't a statistically significant difference at following visits (p>0.05). As a conclusion it was seen that CPM (IV) and oral prednisone treatment which we used as immunosuppressive was effective in SLE.